Swelling of Scrotum and Penis (Henoch-Schönlein Purpura)

skro_20a_n.jpg and skro_20b_n.jpg: 2-year-old boy with a severe bilateral swelling of the scrotum and the penis. The massive bilateral swelling is combined with extensive and petechial bleedings. The diagnosis is scrotal swelling in Henoch-Schönlein purpura. The described findings are typical for this disease entity; however, if the scrotum is the only localization, or if the findings on the remaining body are minimal, the differential diagnosis includes a progressed stage of torsion of the testis, a blunt trauma to the genitals, or a coagulopathy. An ultrasound is necessary in every case because in Henoch-Schönlein purpura often an edema of the testis, epididymis, and spermatic cord may occur, and rarely a combined torsion of the testis.